TIMOTHY STEPHEN DESANTIS

BOISE, ID
NPI1861837601
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID  LCPC-4671)
Enumeration Date2013-05-07
Last Update Date2013-05-07
Business Address
Mr. TIMOTHY STEPHEN DESANTIS LCPC
8620 W EMERALD ST SUITE 150
BOISE, ID 83704-4824
Phone number: 208-672-2900
Mailing Address
Mr. TIMOTHY STEPHEN DESANTIS LCPC
1410 CHELSEY CIR
MOUNTAIN HOME, ID 83647-4634
Phone number: 208-672-8764
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